I have been collecting medical debt for over 20 years. So many things have changed since I started. Small practices have been swallowed up by larger ones, patient out-of-pocket expenses have skyrocketed, technology has changed the way people pay and the enforcement of laws governing debt collection and medical privacy has increased.
One thing, however has not changed. Health insurance is not easy for most consumers to understand. I speak often with frustrated consumers who dutifully pay their insurance premiums each month and wonder why insurance did not cover the cost. Yesterday I had a 3-way conversation with a patient and her insurance company. The woman wanted to pay, and finally did pay her bill, but did not understand how the balance came to be.
I am of the opinion that we all should know how our insurance plans work. We should understand the difference between a copay and coinsurance, how a deductible works and when an insurance sublimit will apply. They should make sure any new medical provider accepts and is in network with their insurance company, and verify if a procedure is covered before they have it.
However, I live in the real world, and I understand that most people are either not willing or do not know how to learn more about their insurance. So, it becomes important that medical providers do everything they can to make sure they communicate well to their patients.
Every patient should complete and sign a financial responsibility agreement with you. The statement should clearly indicate who is responsible for any amounts not paid by health insurance. You can also use this form to let patients know that they are responsible for any cost of collection. These agreements should be updated at least once a year.
Even innocuous statements made to statements can be misconstrued. When I contact a patient regarding a debt, I all too often hear them say that they were told they were , “all set”, a statement which they interpret as meaning that they do not owe any money.
Another issue we often see is that some medical practitioners continue to see patients who owe them significant amounts of money. While we understand that in some instances, a medical condition or an ongoing process (such as orthodontia) make it impossible to discontinue services, there are many instances where you can discontinue.
My medical clients who do not allow patients to make new, non-emergency appointments if they have unpaid balances are seeing a marked improvement in their cash flow and are having to send fewer accounts for outside collection. So, if you have leverage, use it!
As with most business transactions, better communication is everything. Sure, you can always have patients who do not pay you for any number of reasons, even if you do everything right. However, attention to the details in communicating with patients can never hurt and will help you avoid problems down the road